Similar Webssite - Basic Simple

Similar to this site: [login to view URL] 1. Optin Will First Name Last Name and Email Only - To be stored in a flat file on server (No autoresponder, no mail chimp.. just store/write the data in a flat file) 2. When Checkmark "I agree" is checked - a pop behind will open just like the example site. - Then they press the button and are redirected to another website. Simple 3. Optin and Heading / Text ($1000.00 Loans) Must be visible in mobile 4. No Logo - Just Image Saying Website Name 5. Customer will come from an email link like [login to view URL]@test.com&data=Pre Approval of funds - This data will be pre-populated and you need to make print at the top of the website in perhaps 36px like this: First Name Last Name Pre Approval of Funds 5a. The first name, last name and email also need to pre-populate the optin form. 6. See image - You'll need to copy terms, policy and unsubscribe just exactly as they are and replace their business name and address with with my own